HomeMy WebLinkAboutX2019-0995 - MiscX2019-pq5
3501 S9 m 6oree Rd
Inland Air Balance, Inc.
482 W. Arrow Hwy. St. C
San Dimas, CA. 91773
(909)305-4881
LIC # 837772
Air Balance Project Summary
PROJECT: OCCM - 3501 JAMBOREE ROAD, SUITE 540, NEWPORT BEACH 92660
JOB # 1904-165 TECHNICIAN: DJ, RB, AA DATE 4/29/2019
CONTRACTOR: WHITE MECHANICAL
VAV 5-2
BOX OPEN 100%
VAV 5-4
SCHEDULE SHOWS 10" BOX - EXISITING BOX IS 8"
VAV 5-5
BOX OPEN 100%
VAV 5-7
NO POWER TO FAN/HEATER
VAV 5-9
NO POWER TO FANIHEATER
VAV 5-13
OUTLETS 3, 4 & 5 DELETED
zeo�ow-�
Inland Air Balance, Inc,
V
Test and Balance Report
OCCM
SUITE 540
NEWPORT BEACH
Job Address:
3501 JAMBOREE ROAD 92660
Job Number:
1904-165
Technician:
D. JONES, R. BOGLE, A. ABEL
Contractor
WHITE MECHANICAL
Date:
4/29/2019
THE DATA PRESENTED IN THIS REPORT IS A RECORD OF SYSTEM MEASUREMENTS AND FINAL
ADJUSTMENTS THAT HAVE BEEN OBTAINED IN ACCORDANCE WITH THE CURRENT EDITION
OF THE NEBB PROCEDURAL STANDARDS FOR TESTING, ADJUSTING, AND BALANCING OF
ENVIROMENTAL SYSTEMS. THE MEASURMENTS SHOWN, AND THE INFORMATION GIVEN, IN
THIS REPORT ARE CERTIFIED TO BE ACCURATE AND COMPETE, AT THE TIME AND DATE
INFORMATION WAS GATHERED. ANY VARIANCES FROM DESIGN QUANTITIES, WHICH EXCEED
NEBB TOLERANCES, ARE NOTED IN THE TEST - ADJUST - BALANCE REPORT PROJECT SUMMARY.
Inland Air Balance, Inc.
SYMBOL SHEET
BHP
Brake Horse Power
CFM
Cubic Feet per Minute
CHWR
Chilled Water Return
CHWS
Chilled Water Supply
CSD
Ceiling Supply Diffuser
CSG
Ceiling Supply Grille
CWR
Condensor Water Return
CWS
Condensor Water Supply
D.A.
Direct Acting
DNA
Data Not Available
DT
Duct Traverse
EAT
Entering Air Temperature
EG
Exhaust Grill
ESP
External Static Pressure
EWT
Entering Water Temperature
FLA
Full Load Amps
FPM
Feet per Minute
GF
Grease Filter
HP
Horse Power
HWR
Hot Water Return
HWS
Hot Water Supply
LAT
Leaving Air Temperature
LSD
Linear Slot Diffuser
LWT
Leaving Water Temperature
MAT
Mixed Air Temperature
N.A.
Not Accessible
N. 1.
Not Installed
N.L.
Not Listed
N.S.
Not Shown
OSA
Outside Air
R.A
Reverse Acting
RA
Return Air
RG
Return Grill
RPM
Revolutions per Minute
SA
Supply Air
SP
Static Pressure
SWG
Sidewall Diffuser
T.B.D.
To Be Determined
TSP
Total Static Pressure
T -STAT
Thermostat
UTR
Unable to Read
Air Volume
Inland Air Balance, Inc.
VAV TERMINAL TEST REPORT
Project OCCM - SUITE 540 System EXISTING
3501 JAMBOREE ROAD, NEWPORT BEACH 92660 Date 4/29/2019
Job # 1904-165
VAV TERMINAL DATA
NUMBER
E 5-1
DESIGN
ACTUAL
NOTES
TYPE
PNEUMATIC
PRIMARY MAX AIRFLOW C.F.M.
760
760
1
SIZE
8"
PRIMARY MIN AIRFLOW C.F.M.
140
145
DDC CORRECTION
FACTOR
HEATING AIRFLOW C.F.M.
300
318
VAV OUTLET DATA
ROOM
OUTLET
SIZE
AK
TYPE
REQUIRED
ACTUAL
FACTOR•
MAX
I MIN
MAX
MIN
510
1
2410
1.0
CD
250
261
511
2
2410
1.0
CD
250
248
512
3
2410
1.0
CD
250
310
251
331
TOTAL
750
140
760
145
VAV TERMINAL DATA
NUMBER
E 5-2
DESIGN
ACTUAL
NOTES
TYPE
PNEUMATIC
PRIMARY MAX AIRFLOW C.F.M.
1700
1460
1
SIZE
12"
PRIMARY MIN AIRFLOW C.F.M.
310
331
DDC CORRECTION
FACTOR
HEATING AIRFLOW C.F.M.
1100
1024
VAV OUTLET DATA
ROOM
OUTLET
SIZE
AK
TWE
REQUIRED
ACTUAL
FACTOR•
MAX
I MIN
MAX
MIN
509
1
2414
1.0
CD
850
739
509
2
2414
1.0
CD
850
721
TOTAL
1700
310
1460
331
NOTE: If AK=1.0, Velocity information and measurements are not required
NOTES- (1) BOX OPEN 100%
Readings By: DJ, RB, AA
VAV TERMINAL TEST REPORT
Project OCCM - SUITE
3501 JAMBOREE ROAD, NEWPORT BEACH 92660
VAV TERMINAL DATA
Inland Air Balance, Inc.
System
EXISTING
Date
4/29/2019
Job #
1904-165
NUMBER
E 5-3
DESIGN
ACTUAL
NOTES
TYPE
PNEUMATIC
PRIMARY MAX AIRFLOW C.F.M.
900
962
SIZE
8"
PRIMARY MIN AIRFLOW C.F.M.
160
171
DDC CORRECTION
FACTOR
HEATING AIRFLOW C.F.M.
400
429
VAV OUTLET DATA
ROOM
OUTLET
SIZE
AK
TYPE
I REQUIRED
ACTUAL
FACTOR'.
MAX
MIN
MAX
MIN
513
1
2414
1.0
CD
900
962
513
2
2412
1.0
TOTAL
900
160
962
171
TOTAL
1120
200
828
214
-
-
Eli
VAV TERMINAL DATA
NUMBER
E 5-4
DESIGN
ACTUAL
NOTES
TYPE
PNEUMATIC
PRIMARY MAX AIRFLOW C.F.M.
1120
828
SIZE
10'-(l)
PRIMARY MIN AIRFLOW C.F.M.
200
214
DDC CORRECTION
FACTOR
HEATING AIRFLOW C.F.M.
600
598
VAV OUTLET DATA
ROOM
OUTLET
SIZE
I AK
TYPE
REQUIRED
ACTUAL
FACTOR'
MAX
MIN
MAX
MIN
513
1
2412
1.0
CD
560
419
513
2
2412
1.0
CD
560
409
TOTAL
1120
200
828
214
-
-
Eli
NOTE: If AK=1.0, Velocity information and measurements are not required Readings By: DJ, RB, AA
NOTES- (1) SCHEDULE SHOWS 10" BOX- EXISTING BOX IS 8"
Inland Air Balance, Inc.
VAV TERMINAL TEST REPORT
Project OCCM - SUITE 540 System EXISTING
3501 JAMBOREE ROAD, NEWPORT BEACH 92660 Date 4/29/2019
Job # 1904-165
VAV TERMINAL DATA
NUMBER
E 5-5
DESIGN
ACTUAL
NOTES
TYPE
PNEUMATIC
PRIMARY MAX AIRFLOW C.F.M.
1120
920
1
SIZE
1U.
PRIMARY MIN AIRFLOW C.F.M.
200
211
DDC CORRECTION
FACTOR
HEATING AIRFLOW C.F.M.
600
642
VAV OUTLET DATA
ROOM
OUTLET
SIZE
AK
TYPE
REQUIRED
A
FACTOR'
MAX
MIN
MAX
MIN
513
1
2412
1.0
CD
560
454
513
2
2412
1.0
CD
560
150
466
160
TOTAL
1120
200
920
211
VAV TERMINAL DATA
NUMBER
E 5-6
DESIGN
ACTUAL
NOTES
TYPE
PNEUMATIC
PRIMARY MAX AIRFLOW C.F.M.
800
814
SIZE
8"
PRIMARY MIN AIRFLOW C.F.M.
150
160
DDC CORRECTION
FACTOR
HEATING AIRFLOW C.F.M.
400
430
VAV OUTLET DATA
ROOM
OUTLET
SIZE
AK
TYPE
REQUIRED
ACTUAL
FACTOR`
MAX
MIN
MAX
MIN
513
1
2414
1.0
CD
800
814
TOTAL
800
150
814
160
" NOTE: If AK=1.0, Velocity information and measurements are not required
NOTES• (1) BOX OPEN 100%
Readings By: DJ, RB, AA
VAV TERMINAL TEST REPORT
Project OCCM - SUITE 540
3501 JAMBOREE ROAD, NEWPORT BEACH 92660
VAV TERMINAL DATA
Inland Air Balance, Inc.
System
EXISTING
Date
4/29/2019
Job #
1904-165
NUMBER
E 5-7
DESIGN
ACTUAL
NOTES
TYPE
PNEUMATIC
PRIMARY MAX AIRFLOW C.F.M.
1760
1528
SIZE
12"
PRIMARY MIN AIRFLOW C.F.M.
320
338
DOC CORRECTION
FACTOR
HEATING AIRFLOW C.F.M.
1100
413
1
VAV OUTLET DATA
ROOM
OUTLET
SIZE
AK
TYPE
REQUIRED
ACTUAL
FACTOR*
MAX
MIN
MAX
MIN
514
1
2410
1.0
CD
400
384
514
2
2410
1.0
CD
400
381
514
3
2410
1.0
CD
400
130
387
141
514
4
2410
1.0
CD
400
376
TOTAL
1600
1 320
1526
1338
-
I
d
VAV TERMINAL DATA
NUMBER
E 5-8
DESIGN
ACTUAL
NOTES
TYPE
PNEUMATIC
PRIMARY MAX AIRFLOW C.F.M.
740763
SIZE
8"
PRIMARY MIN AIRFLOW C.F.M.
130
141
DDC CORRECTION
FACTOR
HEATING AIRFLOW C.F.M.
400
413
VAV OUTLET DATA
ROOM
OUTLET
SIZE
AK
TYPE
REQUIRED
ACTUAL
FACTOR*
MAX
MIN
MAX
MIN
515
1
2410
1.0
CD
400
379
515
2
2410
1.0
CD
400
384
TOTAL
800
130
763
141
1
-
I
d
NOTE: If AK=1.0, Velocity information and measurements are not required Readings By: DJ, RB, AA
NOTES- (1) NO POWER TO FAN/HEATER
Inland Air Balance, Inc.
VAV TERMINAL TEST REPORT
Project OCCM - SUITE 540 System EXISTING
3501 JAMBOREE ROAD, NEWPORT BEACH 92660 Date 4/29/2019
Job # 1904-165
VAV TERMINAL DATA
NUMBER
E 5-9
DESIGN
ACTUAL
NOTES
TYPE
PNEUMATIC
PRIMARY MAX AIRFLOW C.F.M.
1220
1249
SIZE
12"
PRIMARY MIN AIRFLOW C.F.M.
220
206
DDC CORRECTION
FACTOR
HEATING AIRFLOW C.F.M.
800
1
VAV OUTLET DATA
ROOM
OUTLET SIZE
AK
TYPE
REQUIRED
ACTUAL
.ACTUAL
FACTOR'
MAX
MIN
MAX
MIN
516
1 2410
1.0
CD
325
1.0
316
160
516
2 2410
1.0
CD
325
2408
309
CD
516
3 2410
1.0
CD
325
314
516
4 2410
1.0
CD
325
310
TOTAL
1300 1
220
1249 1206
VAV TERMINAL DATA
NUMBER
E 5-10
DESIGN
ACTUAL
NOTES
TYPE
PNEUMATIC
PRIMARY MAX AIRFLOW C.F.M.
320
338
SIZE
6"
PRIMARY MIN AIRFLOW C.F.M.
100
105
DDC CORRECTION
FACTOR
HEATING AIRFLOW C.F.M.
VAV OUTLET DATA
ROOM
OUTLET
SIZE
AK
TYPE
REQUIRED
.ACTUAL
FACTOR`
MAX
I MIN
I MAX
MIN
517
1
2408
1.0
CD
160
171
517
2
2408
1.0
CD
160
167
TOTAL
320
100
338
105
NOTE: If AK=1.0, Velocity information and measurements are not required Readings By: DJ, RB, AA
NOTES- (1) NO POWER TO FANMEATER
Inland Air Balance, Inc.
VAV TERMINAL TEST REPORT
Project OCCM - SUITE 540 System EXISTING
3501 JAMBOREE ROAD, NEWPORT BEACH 92660 Date 4/29/2019
Job # 1904-165
VAV TERMINAL DATA
NUMBER
E 5-11
DESIGN
ACTUAL
NOTES
TYPE
PNEUMATIC
PRIMARY MAX AIRFLOW C.F.M.
260
277
SIZE
6"
PRIMARY MIN AIRFLOW C.F.M.
80
86
DOC CORRECTION
FACTOR
HEATING AIRFLOW C.F.M.
VAV OUTLET DATA
ROOM
OUTLET
SIZE
AK
TYPE
REQUIRED
ACTUAL
FACTOR'
MAX
MIN
MAX
MIN
500
1
2408
1.0
CD
130
141
500
2
2408
1.0
CD
130
150
136
160
TOTAL
260
80
277
86
VAV TERMINAL DATA
NUMBER
E 5-12
DESIGN
ACTUAL
NOTES
TYPE
PNEUMATIC
PRIMARY MAX AIRFLOW C.F.M.
500
475
SIZE
6"
PRIMARY MIN AIRFLOW C.F.M.
150
142
DDC CORRECTION
FACTOR
HEATING AIRFLOW C.F.M.
VAV OUTLET DATA
ROOM'
OUTLET
SIZE
AK
TYPE
REQUIRED
ACTUAL
FACTOR*
MAX
I MIN
I MAX
MIN
502
1
2412
1.0
CD
500
475
TOTAL
500
150
142
160
NOTE: If AK=1.0, Velocity information and measurements are not required Readings By: DJ, RB, AA
NOTES-
VAV TERMINAL TEST REPORT
Project OCCM - SUITE 540
3501 JAMBOREE ROAD, NEWPORT BEACH 92660
VAV TERMINAL DATA
Inland Air Balance, Inc.
System
EXISTING
Date
4/29/2019
Job #
1904-165
NUMBER
E 5-13
DESIGN
ACTUAL
NOTES
TYPE
PNEUMATIC
PRIMARY MAX AIRFLOWC.F.M.
520
217
1
SIZE
8"
PRIMARY MIN AIRFLOW C.F.M.
160
63
1
DDC CORRECTION
FACTOR
HEATING AIRFLOW C.F.M.
VAV OUTLET DATA
ROOM OUTLET
SIZE AK
TYPE
REQUIRED ACTUAL
TYPE
FACTOR'
ACTUAL
MAX
MIN MAX
MIN
518 1
2408 1.0
CD
100
108
MIN
507 2
2408 1.0
CD
100
109
190
506 3
2408 1.0
CD
110
1
2408
505 4
2408 1.0
CD
110
1
504 5
2408 1.0
CD
1 110
1
190
195
TOTAL 1
530
60 217
63
VAV TERMINAL DATA
NUMBER
E 5-14
DESIGN
ACTUAL
NOTES
TYPE
PNEUMATIC
PRIMARY MAX AIRFLOW C.F.M.
1610
1621
SIZE
12"
PRIMARY MIN AIRFLOW C.F.M.
480
472
DDC CORRECTION
FACTOR
HEATING AIRFLOW C.F.M.
VAV OUTLET DATA
ROOM
OUTLET
SIZE
AK
TYPE
REQUIRED
ACTUAL
FACTOR`
MAX
MIN
MAX
MIN
513
1
2408
1.0
CD
190
203
513
2
2408
1.0
CD
190
187
513
3
2408
1.0
CD
190
195
513
4
2408
1.0
CD
190
197
513
5
2408
1.0
CD
1 190
190
501
6
2410
1.0
CD
340
326
506
7
2408
1.0
CD
110
113
505
8
2408
1.0
CD
110
108
504
9
2408
1.0
CD
100
102
TOTAL
1610
480
1621
472
NOTE: If AK=1.0, Velocity information and measurements are not required Readings By: DJ, RB, AA
NOTES- (1) OUTLETS 3,4 & 5 WERE DELETED
Inland Air Balance, Inc.
VAV TERMINAL TEST REPORT
Project OCCM - SUITE 540 System EXISTING
3501 JAMBOREE ROAD, NEWPORT BEACH 92660 Date 4/29/2019
Job # 1904-165
VAV TERMINAL DATA
NUMBER
E 5-15
DESIGN
DESIGN
ACTUAL
NOTES
TYPE
PNEUMATIC
PRIMARY MAX AIRFLOW C.F.M.
480
511
12" PRIMARY MIN AIRFLOW C.F.M.
SIZE
8"
PRIMARY MIN AIRFLOW C.F.M.
140
132
DDC CORRECTION
FACTOR
HEATING AIRFLOW C.F.M.
ROOM
OUTLET
SIZE
VAV OUTLET DATA
ROOM
OUTLET
SIZE
AK
TYPE
REQUIRED
ACTUAL
MAX
I MIN
FACTOR'
MIN
MAX
MIN
MAX
MIN
508
1
2410
1.0
CD
240
2
254
1.0
509
2
2410
1.0
CD
240
3
257
1.0
CD
240
256
TOTAL 1
480
140
511
132
CD
240
256
TOTAL
960
290
1015
301
VAV TERMINAL DATA
NUMBER
E 5-16
DESIGN
ACTUAL
NOTES
TYPE
PNEUMATIC PRIMARY MAX AIRFLOW C.F.M.960
1015
SIZE
12" PRIMARY MIN AIRFLOW C.F.M.
290
301
DDC CORRECTION
FACTOR
HEATING AIRFLOW C.F.M.
VAV OUTLET DATA
ROOM
OUTLET
SIZE
AK
TYPE
REQUIRED
ACTUAL
FACTOR*
MAX
I MIN
MAX
MIN
509
1
2410
1.0
CD
240
253
509
2
2410
1.0
CD
240
250
509
3
2410
1.0
CD
240
256
509
4
2410
1.0
CD
240
256
TOTAL
960
290
1015
301
NOTE: If AK=1.0, Velocity information and measurements are not required Readings By: DJ, RB, AA
NOTES-
CITY OF NEWPORT BEACH Amount:
MUNICIPAL OPERATIONS DEPARTMENT
592 SUPERIOR AVENUE
t`
NEWPORT BEACH CA 92663
(949)644-3055
AnlDemolition Hauler Certification and Deposit Form X4 nb `ree
3501570 mboee
Owner Name: yr f is f .r �._.. r I 1 -
Property Address.`�_>'. A, k
Permittee Name: Phone: <) It ci 7
r
Permit Number:
Franchised Hauler:
Permittee J I hereby certify that I have contracted with the above-mentioned City Franchised Solid
must initial„ t� Waste or Demolition Contractor. I also certify that I understand I must contact the
Municipal Operations Department at (949).644-3064 no less than 24 hours or more
than 72 hours prior to my intent to commence demolition activities. Municipal
Operations staff will inspect demolition site and verify usage of franchised hauler.
City of Newport Beach Municipal Code indicates: A demolition permit deposit, as determined by the
Municipal Operations Director, shall be paid at the time of submitting the demolition permit. Said deposit
II shall be returned to the permittee, at the conclusion of the demolition project assuming permittee follows
applicable laws.
REFUND TO:
j Name: r ! I r
Address_
City, State, Zip: r fi q 1
I, Permittee hereby certify that I understand that a Cit Franchised Hauler must For Finance Use Only
Permittee ( ) Y fY Y
must sign be used to transport all construction and demolition debris generated as a result of
and date the demolition referenced above. I agree that the deposit will be forfeited if 1) a City
franchised hauler is not used to haul construction and demolition debris from this
project or 2) 1fail to notify the Municipal Opefations Department at (949) 644-
3064 no less than 24 hours or more than 72 hours in advance of my intent to
commence demolition activities.
X f Date
stBldg Issued B 1
y "" � ;''� � � � '; Date
For MOD Notification Date E.'' Demo Date:
j Staff Use
Hauler:
Distribution: White: Municipal Operations Yellow: Refund Goldenrod: Finance Pink: Applicant
Revised March 2018
X201A0995
35�� 5 )M6Oree
Enforcement Agency Use: Checked by/Date
LIGHTING CONTROL ACCEPTANCE DOCUMENT
Automatic Shut-off Controls: Automatic Time Switch Control and Occupant Sensor
Intent: Lights are turned off or set to a lower level when not needed per Section 110.9(a) & 130.1(c).
A. Construction Inspection
Fill out Section A to cover spaces 1 through 3 that are functionally tested under Section B.
Instruments needed to perform tests include, but are not limited to: hand-held amperage meter, power meter, or light meter
1: Automatic Time Switch Controls Construction Inspection—confirm for all listed in Section B
a. All automatic time switch controls are programmed for (check all):
Weekdays 17 Weekend 17 Holidays
b. Document for the owner automatic time switch programming (check all):
Weekday settings K' Weekend settings F Holidays settings 17, Set-up settings
Preference program setting r4 Verify the correct time and date is properly set in the time switch
'aE•a Verify the battery is installed and energized F, Override time limit is no more than 2 hours
CC Occupant Sensors and Automatic Time Switch Controls have been certified to the Energy Commission in accordance with
the applicable provision in Section 110.9 of the Standards, and model numbers for all such controls are listed on the Commission
database as Certified Appliance and Control Devices
2. Occupancy Sensor Construction Inspection—confirm for all listed in Section B
Occupancy sensors are not located within 4 feet of any HVAC diffuser
Ultrasonic occupancy sensors do not emit audible sound 5 feet from source
This is page 1 of 23
CERTIFICATE OF ACCEPTANCE NBCA-LTI-o2-A
Luting Contra]
Project Neme'. OCCM Enforcement Agency: CITY OF NEWPORT BEACH
Permit Number'. X2019-0995
Project Address: 3501 Jamboree, Ste. 540 City: Newport Beach
Zip Code: 926
B. Functional Testing of Lighting Controls
For every space in the building, conduct functional tests 1 through 5 below if applicable. If there are several geometrically similar spaces
that use the same lighting controls, test only one space and list in the cells below which "untested spaces" are represented by that
tested space. EXCEPTION: For buildings with up to seven (7) occupancy sensors, all occupancy sensors shall be tested. (NA7.6.2.3)
Representative Spaces Selected
Tested space/room name: Private Office 518
Space Type (office, corridor, etc) Office
Untested areas/rooms
Confirm compliance for all control system types (1-5) present in each space:
1. Automatic Time Switch Controls
Step 1: Simulate occupied condition
a. All lights can be turned on and off by their respective area control switch l
b. Verify the switch only operates lighting in the ceiling -height partitioned area in
which the switch is located.
Step 2: Simulate unoccupied condition
a. All lighting, including emergency and egress lighting, turns off. Exempt lighting may
remain on per Section 130.1(c)1 and 130.1(a)1,
b. Manual override switch controls only the lights in the selected ceiling height
partitioned space where the override switch is located and the lights remain on no
longer than 2 hours (unless serving public areas and override switch is captive key
type).
Step 3:
System returned to initial operating conditions
2. Occupancy Sensors
Step 1: Simulate an unoccupied condition
a. Lights controlled by occupancy sensors turn off within a maximum of 20 minutes
from start of an unoccupied condition per Standard Section 110.9(b) W
b. The occupant sensor does not trigger a false 'on' from movement in an area
adjacent to the controlled space or from HVAC operation.
Step 2: Simulate an occupied condition
a. Status indicator or annunciator operates correctly
b. Lights controlled by occupancy sensors turn on immediately upon an occupied
condition OR sensor indicates space is 'occupied' and lights may be turned on
manually
This is page 2 of 23
Step 3:
System returned to initial operating conditions 17
3. Partial Off Occupancy Sensor
Step 1: Simulate an unoccupied condition
a. Lights go to partial off state within a maximum of 20 minutes from start of an
unoccupied condition per Standard Section 110.9(a)
b. The occupant sensor does not trigger a false 'on' from movement in an area
adjacent to the controlled space or from HVAC operation. For library book stacks or
warehouse aisle, activity beyond the stack or aisle shall not activate the lighting in
the aisle or stack.
c. In the partial off state, lighting shall consume no more than 500% of installed lighting
power, or:
No more than 60% of installed lighting power for metal halide or high pressure
sodium lighting in warehouses.
No more than 60% of installed lighting power for corridors and stairwells in which
the installed lighting power is 80% or less of the value allowed under the Area
Category Method.
Light level may be used as a proxy for lighting power when measurements are taken 17,
Step 2: Simulate an occupied condition
The occupant sensing controls shall turn lights fully ON in each separately controlled
areas, Immediately upon an occupied condition
4. Partial On Occupancy Sensors
Step 1. -Simulate an occupied condition. Verify partial on operation.
a. Immediately upon an occupied condition, the first stage activates between 50 to
70% of the lighting automatically. R,
b. After the first stage occurs, manual switches allow an occupant to activate the
alternate set of lights, activate 100% of the lighting power, and manually
deactivate all of the lights.
Step 2. Simulate an unoccupied condition
a. Both stages (automatic on and manual on) lights turn off within a maximum of 20
minutes from start of an unoccupied condition per Standard Section 110.9(a)
b. The occupant sensor does not trigger a false 'on' from movement in an area
adjacent to the controlled space or from HVAC operation. IF
This is page 3 of 23
5. Additional test for Occupancy Sensors Serving Small Zones in Office Spaces Larger than
250 ftz, to Qualify for a Power Adjustment Factor (PAF)
Step O: First, complete Functional Test 2 (above) for each controlled zone.
Step 1: Verify area served and compare actual PAF with claimed PAF. Refer to Functional Test 2.
a. Area served by controlled lighting ft2
b. Enter PAF corresponding to controlled area from line (a) above (<125 ft2 for
PAF=0.4, 126-250 ft2 for PAF=0.3, 251-500 ft2 for PAF=0.2).
c. Enter PAF claimed for occupant sensor control in this space from the Certificate of
Compliance.
d. The PAF corresponding to the controlled area (line b), is greater than or equal to
the PAF claimed in the compliance documentation (line c). "'
e. Sensors shall not trigger in response to movement in adjacent walkways or
workspaces M
f. All steps are conducted in Functional Test 2 'Occupancy Sensor (On Off Control)',
and all answers are Yes.
This is page 4 of 23
C. Testing Results
1. Automatic Time Switch Controls (all answers must be Yes). iTM-
2. Occupancy Sensor (On Off Control) (all answers must be Yes). W,
3. Partial Off Occupancy Sensor (all answers must be Yes). For warehouses, library
book stacks, corridors, stairwells in nonresidential buildings must also be _
accompanied by passing Test 1 or Test 2.
4. Partial On Occupant Sensor for PAF (all answers must be Yes).
5. Occupant Sensor serving small zones for PAF (all answers must be Yes). Also must
pass Test 2.71
Representative Spaces Selected
Tested space/room name: Office 510
Space Type (office, corridor, etc) Office
Untested areas/rooms
Confirm compliance for all control system types (1-5) present in each space:
1. Automatic Time Switch Controls
Step 1: Simulate occupied condition
a. All lights can be turned on and off by their respective area control switch'
b. Verify the switch only operates lighting in the ceiling -height partitioned area in
which the switch Is located.
Step 2: Simulate unoccupied condition
a. All lighting, including emergency and egress lighting, turns off. Exempt lighting may
remain on per Section 130.1(c)1 and 130.1(a)1. F
b. Manual override switch controls only the lights in the selected ceiling height
partitioned space where the override switch is located and the lights remain on no
longer than 2 hours (unless serving public areas and override switch is captive key
type). FT
Step 3:
System returned to initial operating conditions
2. Occupancy Sensors
Step 1: Simulate an unoccupied condition
This is page 5 of 23
X2019-0995
a. Lights controlled by occupancy sensors turn off within a maximum of 20 minutes
from start of an unoccupied condition per Standard Section 110.9(b)
15
b. The occupant sensor does not trigger a false 'on' from movement in an area
adjacent to the controlled space or from HVAC operation. r''
Step 2: Simulate an occupied condition
a. Status indicator or annunciator operates correctly W
b. Lights controlled by occupancy sensors turn on immediately upon an occupied
condition OR sensor indicates space is 'occupied' and lights may be turned on
manually
Step 3:
System returned to initial operating conditions E7
3. Partial Off Occupancy Sensor
Step 1: Simulate an unoccupied condition
a. Lights go to partial off state within a maximum of 20 minutes from start of an
unoccupied condition per Standard Section 110.9(a) 17
b. The occupant sensor does not trigger a false 'on' from movement in an area
adjacent to the controlled space or from HVAC operation. For library book stacks or
warehouse aisle, activity beyond the stack or aisle shall not activate the lighting in
the aisle or stack. 1
c. In the partial off state, lighting shall consume no more than 50% of installed lighting
power, or:
No more than 60% of installed lighting power for metal halide or high pressure
sodium lighting in warehouses.
No more than 600% of installed lighting power for corridors and stairwells in which
the installed lighting power is 80% or less of the value allowed under the Area
Category Method.
Light level may be used as a proxy for lighting power when measurements are taken
Step 2: Simulate an occupied condition
The occupant sensing controls shall turn lights fully ON in each separately controlled
areas, Immediately upon an occupied condition
4. Partial On Occupancy Sensors
Step 1. -Simulate an occupied condition. Verify partial on operation.
a. Immediately upon an occupied condition, the first stage activates between 50 to
70% of the lighting automatically.
b. After the first stage occurs, manual switches allow an occupant to activate. the
alternate set of lights, activate 100% of the lighting power, and manually FMdeactivate all of the lights.
This is page 6 of 23
Step 2. Simulate an unoccupied condition
a. Both stages (automatic on and manual on) lights turn off within a maximum of 20
minutes from start of an unoccupied condition per Standard Section 110.9(a) G
J. The occupant sensor does not trigger a false 'on' from movement in an area
adjacent to the controlled space or from HVAC operation. 1 174,
This is page 7 of 23
5. Additional test for Occupancy Sensors Serving Small Zones in Office Spaces larger than
250 ft , to Qualify for a Power Adjustment Factor (PAF)
Step 0: First, complete Functional Test 2 (above) for each controlled zone.
Step 1: Verify area served and compare actual PAF with claimed PAF. Refer to Functional Test 2.
a. Area served by controlled lighting ft2
b. Enter PAF corresponding to controlled area from line (a) above (<125 ft2 for
PAF=0.4, 126-250 ft2 for PAF=0.3, 251-500 ft2 for PAF=0.2).
c. Enter PAF claimed for occupant sensor control in this space from the Certificate of
Compliance.
d. The PAF corresponding to the controlled area (line b), is greater than or equal to
the PAF claimed in the compliance documentation (line c), r7—
e.
e. Sensors shall not trigger in response to movement in adjacent walkways or
workspaces 1 F7
f. All steps are conducted in Functional Test 2 'Occupancy Sensor (On Off Control)'
and all answers are Yes.
This is page 8 of 23
ACCEPTANCE
X2019-0995
C. Testing Results
1. Automatic Time Switch Controls (all answers must be Yes). r
2. Occupancy Sensor (On Off Control) (all answers must be Yes). R
3. Partial Off Occupancy Sensor (all answers must be Yes). For warehouses, library
book stacks, corridors, stairwells in nonresidential buildings must also be
accompanied by passing Test i or Test 2. r7L
4. Partial On Occupant Sensor for PAF (all answers must be Yes). 1 171
5. Occupant Sensor serving small zones for PAF (all answers must be Yes). Also must
pass Test 2, r'
Representative Spaces Selected
Tested space/room name: Office 512
Space Type (office, corridor, etc) Office
Untested areas/rooms
Confirm compliance for all control system types (1-5) present in each space:
1. Automatic Time Switch Controls
Step 1: Simulate occupied condition
a. All lights can be turned on and off by their respective area control switch I F111
b. Verify the switch only operates lighting in the ceiling -height partitioned area in
which the switch is located.
Step 2: Simulate unoccupied condition
a. All lighting, Including emergency and egress lighting, turns off. Exempt lighting may
remain on per Section 130.1(c)1 and 130.1(a)1.
b. Manual override switch controls only the lights in the selected ceiling height
partitioned space where the override switch is located and the lights remain on no
longer than 2 hours (unless serving public areas and override switch is captive key
type). F7
Step 3:
System returned to initial operating conditions m
2. Occupancy Sensors
Step 1: Simulate an unoccupied condition
This is page 9 of 23
CERTIFICATE OF ACCEPTANCE NRCA-LTI-02-A
Lighting Control
Project Name: OCCM
Enforcement Agency: CITY OF NEWPORT BEACH JlPemtit NumberX2019-0995
Project Address'. 3501 Jamboree, Ste. 5+0
City: Newport Beach Zip Code: 92MO
a. Lights controlled by occupancy sensors turn off within a maximum of 20 minutes
from start of an unoccupied condition per Standard Section 110.9(b)
b. The occupant sensor does not trigger a false 'on' from movement in an area
adjacent to the controlled space or from HVAC operation. R
Step 2: Simulate an occupied condition
a. Status indicator or annunciator operates correctly FZ
b. Lights controlled by occupancy sensors turn on immediately upon an occupied
condition OR sensor indicates space is 'occupied' and lights may be turned on
manually r'-
Step 3:
System returned to initial operating conditions
3. Partial Off Occupancy Sensor
Step 1: Simulate an unoccupied condition
a. Lights go to partial off state within a maximum of 20 minutes from start of an
unoccupied condition per Standard Section 110,9(a) F7
b. The occupant sensor does not trigger a false 'on' from movement in an area
adjacent to the controlled space or from HVAC operation, For library book stacks or
warehouse aisle, activity beyond the stack or aisle shall not activate the lighting in
the aisle or stack.
c. In the partial off state, lighting shall consume no more than 50% of installed lighting
power, or:
No more than 60% of installed lighting power for metal halide or high pressure
sodium lighting in warehouses.
No more than 60% of installed lighting power for corridors and stairwells in which
the installed lighting power is 80% or less of the value allowed under the Area
Category Method.
Light level may be used as a proxy for lighting power when measurements are taken 17
Step 2: Simulate an occupied condition
The occupant sensing controls shall turn lights fully ON in each separately controlled
areas, Immediately upon an occupied condition
4. Partial On Occupancy Sensors
Step 1. -Simulate an occupied condition. Verify partial on operation.
a. Immediately upon an occupied condition, the first stage activates between 50 to
70% of the lighting automatically. 1 17
b. After the first stage occurs, manual switches allow an occupant to activate the
alternate set of lights, activate 100% of the lighting power, and manually
deactivate all of the lights.
This is page 10 of 23
Step 2. Simulate an unoccupied condition
a. Both stages (automatic on and manual on) lights turn off within a maximum of 20
minutes from start of an unoccupied condition per Standard Section 110.9(a)
b. The occupant sensor does not trigger a false 'on' from movement in an area
adjacent to the controlled space or from HVAC operation.
This is page 11 of 23
Name: OCCM
540
5. Additional test for Occupancy Sensors Serving Small Zones in Office Spaces Larger than
250 ft , to Qualify for a Power Adjustment Factor (PAF)
Step 0: First, complete Functional Test 2 (above) for each controlled zone.
Step 1: Verify area served and compare actual PAF with claimed PAF. Refer to Functional Test 2.
a. Area served by controlled lighting ft2
b. Enter PAF corresponding to controlled area from line (a) above (<125 ft2 for
PAF=0.4, 126-250 ft2 for PAF=0.3, 251-500 ft2 for PAF=0.2).
c. Enter PAF claimed for occupant sensor control in this space from the Certificate of
Compliance.
d. The PAF corresponding to the controlled area (line b), is greater than or equal to
the PAF claimed in the compliance documentation (line c).
e, Sensors shall not trigger in response to movement in adjacent walkways or
workspaces
f. All steps are conducted in Functional Test 2 'Occupancy Sensor (On Off Control)'
and all answers are Yes. RI
This is page 12 of 23
C. Testing Results
1. Automatic Time Switch Controls (all answers must be Yes). ��
2. Occupancy Sensor (On Off Control) (all answers must be Yes).
3. Partial Off Occupancy Sensor (all answers must be Yes). For warehouses, library
book stacks, corridors, stairwells in nonresidential buildings must also be
accompanied by passing Test 1 or Test 2.'
4, Partial On Occupant Sensor for PAF (all answers must be Yes). 1 171
5. Occupant Sensor serving small zones for PAF (all answers must be Yes). Also must
pass Test 2.
Representative Spaces Selected
Tested space/room name: Private Office 508
Space Type (office, corridor, etc) Office
Untested areas/rooms
Confirm compliance for all control system types (1-5) present in each space:
1. Automatic Time Switch Controls
Step 1: Simulate occupied condition
a. All lights can be turned on and off by their respective area control switch F
b. Verify the switch only operates lighting in the ceiling -height partitioned area in
which the switch is located.
Step 2: Simulate unoccupied condition
a. All lighting, including emergency and egress lighting, turns off. Exempt lighting may
remain on per Section 130.1(c)1 and 130.1(a)1.
b. Manual override switch controls only the lights in the selected ceiling height
partitioned space where the override switch is located and the lights remain on no
longer than 2 hours (unless serving public areas and override switch is captive key
type). 1117
Step 3:
System returned to initial operating conditions 17
2. Occupancy Sensors
Step 1: Simulate an unoccupied condition
P r
e
This is page 13 of 23
b. The occupant sensor does not trigger a false 'on' from movement in an area
adjacent to the controlled space or from HVAC operation,
Step 2: Simulate an occupied condition
a, Status indicator or annunciator operates correctly 17
b. Lights controlled by occupancy sensors turn on Immediately upon an occupied
condition OR sensor indicates space is 'occupied' and lights may be turned on
manually 17
Step 3:
System returned to initial operating conditions FW
3. Partial Off Occupancy Sensor
Step 1: Simulate an unoccupied condition
a. Lights go to partial off state within a maximum of 20 minutes from start of an
unoccupied condition per Standard Section 110.9(a) R
b. The occupant sensor does not trigger a false 'on' from movement in an area
adjacent to the controlled space or from HVAC operation. For library book stacks or
warehouse aisle, activity beyond the stack or aisle shall not activate the lighting in
the aisle or stack. FT
c. In the partial off state, lighting shall consume no more than 50% of installed lighting
power, or:
No more than 60% of installed lighting power for metal halide or high pressure
sodium lighting in warehouses.
No more than 60% of installed lighting power for corridors and stairwells in which
the installed lighting power is 80% or less of the value allowed under the Area
Category Method.
Light level may be used as a proxy for lighting power when measurements are taken 177,
Step 2: Simulate an occupied condition
The occupant sensing controls shall turn lights fully ON in each separately controlled
areas, Immediately upon an occupied condition 17'
4. Partial On Occupancy Sensors
Step 1. -Simulate an occupied condition. Verify partial on operation.
a. Immediately upon an occupied condition, the first stage activates between 50 to
70% of the lighting automatically.
b. After the first stage occurs, manual switches allow an occupant to activate the
alternate set of lights, activate 100% of the lighting power, and manually
deactivate all of the lights. F1
This is page 14 of 23
Step 2. Simulate an unoccupied condition
a. Both stages (automatic on and manual on) lights turn off within a maximum of 20
minutes from start of an unoccupied condition per Standard Section 110.9(a) r
b. The occupant sensor does not trigger a false 'on' from movement in an area FrI
adjacent to the controlled space or from HVAC operation.
This is page 15 of 23
5. Addf�'tional test for Occupancy Sensors Serving Small Zones in Office Spaces Larger than
250 ft , to Qualify for a Power Adjustment Factor (PAF)
Step 0: First, complete Functional Test 2 (above) for each controlled zone.
Step 1: Verify area served and compare actual PAF with claimed PAF. Refer to Functional Test 2.
a. Area served by controlled lighting ft2
b. Enter PAF corresponding to controlled area from line (a) above (<125 ft2 for
PAF=0.4, 126-250 ft2 for PAF=0.3, 251-500 ft2 for PAF=0.2).
c. Enter PAF claimed for occupant sensor control in this space from the Certificate of
Compliance.
d. The PAF corresponding to the controlled area (line b), is greater than or equal to
the PAF claimed in the compliance documentation (line c), r
e. Sensors shall not trigger in response to movement in adjacent walkways or
workspaces
f. All steps are conducted in Functional Test 2 'Occupancy Sensor (On Off Control)'
and all answers are Yes.
This is page 16 of 23
C. Testing Results
1. Automatic Time Switch Controls (all answers must be Yes), l-:"•_
2. Occupancy Sensor (On Off Control) (all answers must be Yes). W
3. Partial Off Occupancy Sensor (all answers must be Yes). For warehouses, library
book stacks, corridors, stairwells in nonresidential buildings must also be
accompanied by passing Test 1 or Test 2, lx
4. Partial On Occupant Sensor for PAF (all answers must be Yes).
5. Occupant Sensor serving small zones for PAF (all answers must be Yes). Also must
pass Test 2. 1 177
Representative Spaces Selected
Tested space/room name: Office 511
Space Type (office, corridor, etc) Office
Untested areas/rooms
Confirm compliance for all control system types (1-5) present in each space:
1. Automatic Time Switch Controls
Step 1: Simulate occupied condition
a. All lights can be turned on and off by their respective area control switch 1'
b. Verify the switch only operates lighting in the ceiling -height partitioned area in
which the switch is located. 17,
Step 2: Simulate unoccupied condition
a. All lighting, including emergency and egress lighting, turns off. Exempt lighting may
remain on per Section 130.1(c)1 and 130.1(a)1. cr'
b. Manual override switch controls only the lights in the selected ceiling height
partitioned space where the override switch is located and the lights remain on no
longer than 2 hours (unless serving public areas and override switch is captive key
type). 17
Step 3:
System returned to initial operating conditions
2. Occupancy Sensors
Step 1: Simulate an unoccupied condition
This is page 17 of 23
ACCEPTANCE
a, Lights controlled by occupancy sensors turn off within a maximum of 20 minutes
from start of an unoccupied condition per Standard Section 110.9(b)
b, The occupant sensor does not trigger a false 'on' from movement in an area
adjacent to the controlled space or from HVAC operation. 7,
Step 2: Simulate an occupied condition
a. Status indicator or annunciator operates correctly 17
b. Lights controlled by occupancy sensors turn on immediately upon an occupied
condition OR sensor indicates space is 'occupied' and lights may be turned on
manually
Step 3:
System returned to initial operating conditions P:
3. Partial Off Occupancy Sensor
Step 1: Simulate an unoccupied condition
a. Lights go to partial off state within a maximum of 20 minutes from start of an
unoccupied condition per Standard Section 110.9(a)
b. The occupant sensor does not trigger a false 'on' from movement in an area
adjacent to the controlled space or from HVAC operation. For library book stacks or
warehouse aisle, activity beyond the stack or aisle shall not activate the lighting in
the aisle or stack. 17,
c. In the partial off state, lighting shall consume no more than 50% of installed lighting
power, or:
No more than 60% of installed lighting power for metal halide or high pressure
sodium lighting in warehouses.
No more than 60% of installed lighting power for corridors and stairwells in which
the installed lighting power is 80% or less of the value allowed under the Area
Category Method.
Light level may be used as a proxy for lighting power when measurements are taken
Step 2: Simulate an occupied condition
The occupant sensing controls shall turn lights fully ON in each separately controlled
areas, Immediately upon an occupied condition 1 171
4. Partial On Occupancy Sensors
Step 1. -Simulate an occupied condition. Verify partial on operation.
a. Immediately upon an occupied condition, the first stage activates between 50 to
70% of the lighting automatically. rK
b. After the first stage occurs, manual switches allow an occupant to activate the
alternate set of lights, activate 100% of the lighting power, and manually
deactivate all of the lights. 17,
This is page 18 of 23
Step 2. Simulate an unoccupied condition
a. Both stages (automatic on and manual on) lights turn off within a maximum of 20
minutes from start of an unoccupied condition per Standard Section 110.9(a)
b. The occupant sensor does not trigger a false 'on' from movement in an area r
adjacent to the controlled space or from HVAC operation.
This is page 19 of 23
BEACH
(Project Address. 3501 Jamboree, Ste. 540 1
5. Additional test for Occupancy Sensors Serving Small Zones in Office Spaces Larger than
250 ft , to Qualify for a Power Adjustment Factor (PAF)
Step 0: First, complete Functional Test 2 (above) for each controlled zone.
Step 1: Verify area served and compare actual PAF with claimed PAF. Refer to Functional Test 2.
a. Area served by controlled lighting ft2
b. Enter PAF corresponding to controlled area from line (a) above (<125 ft2 for
PAF=0.4, 126-250 ft2 for PAF=0.3, 251-500 ft2 for PAF=0.2).
c. Enter PAF claimed for occupant sensor control in this space from the Certificate of
Compliance.
d. The PAF corresponding to the controlled area (line b), is greater than or equal to 174,
the PAF claimed in the compliance documentation (line c).
e. Sensors shall not trigger in response to movement in adjacent walkways or F7
workspaces
f, All steps are conducted in Functional Test 2'Occupancy Sensor (On Off Control)'
and all answers are Yes.
This is page 20 of 23
1. Automatic Time Switch Controls (all answers must be Yes).
2. Occupancy Sensor (On Off Control) (all answers must be Yes). W
3. Partial Off Occupancy Sensor (all answers must be Yes). For warehouses, library
book stacks, corridors, stairwells in nonresidential buildings must also be
accompanied by passing Test 1 or Test 2. rT
4. Partial On Occupant Sensor for PAF (all answers must be Yes). r7'
S. Occupant Sensor serving small zones for PAF (all answers must be Yes). Also must
pass Test 2.
D. Evaluation :
R PASS: All applicable Construction Inspection responses are complete and all applicable
Equipment Testing Requirements responses are positive.
This is page 21 of 23
OFACCEFCANCE
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT
I certify that this Certificate of Acceptance documentation is accurate and complete.
Documentation Author Company Name
Name Bruce Wood hall
Helmco Electric, Inc.
Address City
17985 Sky Park Circle, Ste. 3
Irvine
Zip Code Phone
92614
(661)468-5638
CEA/ATT Certification TC -A217220
Author Signature
Identification (if
applicable)
-b0JLJ
Date of Signature: 06117/2019
FIELD TECHNICIAN'S DECLARATION STATEMENT
I certify the following under penalty of perjury, under the laws of the State of California:
1. The Information provided on this Certificate of Acceptance is true and correct.
2. 1 am the person who performed the acceptance verification reported an this Certificate of Acceptance (Field Technician).
3. The construction or installation identified on this Certificate of Acceptance complies with the applicable acceptance requirements indicated In the plans and
specifications approved by the enforcement agency, and conforms to the applicable acceptance requirements and procedures specified in Reference
Nonresidential Appendix NA7.
4. I have confirmed that the Certificate(s) of Installation for the construction or installation identified on this Certificate of Acceptance has been completed and
signed by the responsible builder/installer and has been posted or made available with the building permit(s) issued for the building.
Field Technician Name Company Name
Bruce Wood hail Helmco Electric, Inc.
Address: 17965 Sky Park Circle, Ste. 3 City Irvine
Zip Code 92614 Phone (661)468-5638
ATT Certification TC -A217220 Position with Company Su perintentlent
Identification (Title)
Field Technician Signature
Date of Signature: 06/17/2019
RESPONSIBLE PERSON'S DECLARATION STATEMENT
I certify the following under penalty of perjury, under the laws of the State of California:
1. I am the Field Technician, or the Field Technician is acting on my behalf as my employee or my agent and I have reviewed the information provided on this
Certificate of Acceptance.
2, I am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design, construction
of installation of features, materials, components, or manufactured devices for the scope of work identified on this Certificate of Acceptance and attest to the
declarations in this statement (responsible acceptance person).
3. The information provided on this Certificate of Acceptance substantiates that the construction or installation identified on this Certificate of Acceptance complies
with the acceptance requirements indicated in the plans and specifications approved by the enforcement agency, and conforms to the applicable acceptance
requirements and procedures specified in Reference Nonresidential Appendix NA7.
4. 1 have confirmed that the CeitiFlcate(s) of Installation for the construction or installation identified on this Certificate of Acceptance has been completed and is
posted or made available with the building permit(s) issued for the building.
5. I will ensure that a completed, signed copy of this Certificate of Acceptance shall be posted, or made available with the building permit(s) issued for the
building, and made available to the enforcement agency for all applicable inspections. I understand that a signed copy of this Certificate of Acceptance is
required to be Included with the documentation the builder provides to the building owner at occupancy.
Responsible Acceptance Bruce Woodhall Company Name Helmco Electric, Inc.
Person Name
Address: City
17985 Sky Park Circle, Ste. 3 Irvine
Zip Code Phone
92614 (661)466-5638
CSLB License 933623 Position with Company
Title) Superintendent
Responsible Acceptance Person Signature
Date of Signature: 06/17/2019
This is page 22 of 23
This is page 23 of 23
General Information
Building Type:
F Nonresidential 174 High -Rise Res (Common Area)
a(7i-. Hotel/Motel (Common Area)
Phase of Construction:
ru` New Construction F7 Addition
F7 Alteration
174 Unconditioned
Scope of Responsibility
Enter the date of approval by enforcement agency of the Certificate of Compliance that
provides the specifications for the energy
efficiency measures for the scope of responsibility for this Installation Certificate,
Date: 4/11/2019 12:00:00 AM
Document Title e D- • •Tables, -•
Date Approved By the Enforcement
Lighting Control Details E-6.0
4/12/2019 12:00:00 AM
Lighting Plan E-3.0
4/12/2019 12:00:00 AM
Title 24 Forms E-2.0
4/12/2019 12:00:00 AM
Lighting Control Details E-5.0
4/12/2019 12:00:00 AM
Tenant Electrical Master Sheet E-1.0
4/12/2019 12:00:00 AM
This is page 1 of 2
Ki"W1 Made
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT
I certify that this Certificate of Acce ptanne document is accurate and complete.
Documentation Author
Company Name
Name Bruce Wootlhall
Helmco Electric, Inc.
Address
City
17965 Sky Park Circle, Ste. I
Irvine
Zip Code
Phone
92614
(661)468-5638
CEAJATT Certification
Signature
Identification (if TC -A217220
applicable)
A
Date of Signature:
06/17/2019
RESPONSIBLE PERSON'S DECLARATION STATEMENT
I certify the following under penalty of perjury, under the laws of the State of California:
1. I am the Field Technician, or the Field Technician is acting on my behalf as my employee or my agent and I have reviewed the information provided on this
Certificate of Acceptance.
2. 1 am eligible under Division 3 of the Business and Professions Code In the applicable classification to accept responsibility for the system design, construction
or installation of features, materials, components, or manufactu ad devices for the scope of work identified on this Certificate of Acceptance and attest to the
declarations in this statement (responsible acceptance person).
3. The information provided on this Certificate of Acceptance substantiates that the construction or installation identified on this Certificate of Acceptance
complies with the acceptance requirements indicated in the plans and specifications approved by the enforcement agency, and conforms to the applicable
acceptance requirements and procedures specified in Reference Nonresidential Appendix NA7,
4. I have confirmed that the Certificate(s) of Installation for the construction or installation Identified on this Certificate of Acceptance has been completed and
is posted or made available with the building permit(s) issued for the building.
S. I will ensure that a completed, signed copy of this Certificate of Acceptance shall be posted, or made available with the building permit(s) issued for the
building, and made available to the enforcement agency for all applicable Inspections. I understand that a signed copy of this Certificate of Acceptance is
req u i I ad to be included with the documentation the builder provides to the on l Id i ng owner at occupancy.
Responsible Acceptance grace Wootlhall Company Name Helmco Electric, Inc.
Person Name
Address: 17985 Sky Park Circle, Ste. 1
Zip Code
92614
CSI -5 License 933623
Responsible Acceptance Person Signature
Date of Signature: 06/17/2019
City
Irvine
Phone
(661)468-5638
Position with Company
(Title) Superintendent
This is page 2 of 2
sm sio
INDOOR LIGHTING
NRCILTI_02_E
OCCM_
Orange
General Information
Building Type:
9 Nonresidential uHigh-Rise Res (Common Area)
Ik, Hotel/Motel (Common Area)
Phase of Construction:
r New Construction G Addition ( Alteration
r Unconditioned
Scope of Responsibility
Enter the date of approval by enforcement agency of the Certificate of Compliance that provides the specifications for the energy
efficiency measures for the scope of responsibility for this Installation Certificate.
Date: 4/11/2019 12:00:00 AM
§130.4(b) Before an Energy Management Control System (FMCS), or Lighting Control System can be recognized for compliance with
the lighting control requirements in Part 6 of Title 24, the person who is eligible under Division 3 of the Business and Professions Code
to accept responsibility for the construction or installation of features, materials, components, or manufactured devices shall sign and
submit this Installation Certificate.
If any of the requirements in this Installation Certificate fail the Energy Management Control System or Lighting Control System
installation requirements, these options for controlling lighting shall not be recognized for compliance with the Building Energy
Efficiency Standards.
Check all that apply
PART 1 What type of Lighting Control System has been installed?
171 A. Energy Management Control System (EMCS) - Is a computerized control system designed to regulate the energy
consumption of a building by controlling the operation of energy consuming systems, such as the heating,
ventilation and air conditioning (HVAC), lighting, and water heating systems, and is capable of monitoring
environmental and system loads, and adjusting HVAC operations in order to optimize energy usage and respond to
demand response signals.
IIS The Energy Management Control System has been installed to function as a lighting control required by Part
6 and functionally meets all applicable requirements for each application for which it is installed, in
accordance with Sections 110.9, 130.0 through 130.5, 140.6 through 150.0, and 150.2; and complies with
Reference Nonresidential Appendix NA7.7.2.
The EMCS has been separately tested for each respective lighting control system for which it is installed to
function as.
I' B. Lighting Control System - Requires two or more components to be installed in the building to provide all of the
functionality required to make up a fully functional and compliant lighting control.
This is page 1 of 5
CERTIFICATE OF INSTALLATION NRCI-LTI-02-E
EMCS or Lighting Ccntml System
Project Name: OCCM
Enforcement Agency: CITY OF NEWPORT BEACH IlPe,nw Numbs: X2019-0995
Project Address: 3501 Jamboree, Ste. 540
1Zip Cade. 9_660
r The installed Lighting Control System complies with the requirements checked below; and all components of
the system considered together as installed meet all applicable requirements for the application for which
they are installed as required in Sections 130.0 through 130.5, Sections 140.6 through 140.8, Section 141.0,
and Section 150.0(k).
PART 2 Lighting Control Functional requirements: Check all that apply when verifying
the installation of an EMCS or Lighting Control System.
Pr A. All lighting controls and equipment have been installed in accordance with the manufacturer's instructions.
ri B. The manufacturer has provided instructions for calibration.
17 C. If indicator lights are integral to any components, such indicator lights consumes no more than 1 watt of power
per indicator light.
CP D. Components that are regulated by the Title 20 Appliance Efficiency Regulations have been certified to the Energy
Commission.
r E. The EMCS or Lighting Control System functions as one or more of the Time -Switch Lighting Controls checked
below, and complies with all of the following requirements:
1. Automatic Time -Switch Controls meeting all requirements for Automatic Time Switch Control devices in the
Title 20 Appliance Efficiency Regulations, including the requirements below:
a. Residential automatic time -switch controls have program backup capabilities that prevent the loss of the
device's schedule for at least 7 days, and the device's date and time for at least 72 hours if power is
interrupted.
b. Commercial automatic time -switch controls meet the following requirements:
i. Has program backup capabilities that prevent the loss of the device's schedule for at least 7 days, and the
device's date and time for at least 72 hours if power is interrupted
ii. Is capable of providing manual override to each connected load and shall resume normally scheduled
operation after manual override is initiated within 2 hours for each connected load and
ill. Incorporates an automatic holiday shutoff feature that turns off all connected loads for at least 24 hours
and then resumes normally scheduled operation.
77 2. Astronomical Time -Switch Controls meeting all requirements for Astronomical Time -Switch Control devices
in the Title 20 Appliance Efficiency Regulations, including the requirements below:
a. Meets the requirements of an automatic time -switch control
b. Has sunrise and sunset prediction accuracy within plus -or -minus 15 minutes and timekeeping accuracy
within 5 minutes per year
c. Is capable of displaying date, current time, sunrise time, sunset time, and switching times for each step
during programming
d. Has an automatic daylight savings time adjustment; and
e. Has the ability to independently offset the on and off for each channel by at least 99 minutes before and
after sunrise or sunset.
3. Multi -Level Astronomical Time -Switch Controls, in addition to meeting all of the requirements for
Astronomical Time -Switch Controls, includes at least 2 separately programmable steps per zone.
F. The EMCS or Lighting Control System functions as one or more of the Daylighting Controls listed below:
This is page 2 of 5
CERTIFICATE OF INSTALLATION NBCI-LTI-02-E
EMCS or Lighting Control System
Project Name: OCCM
Enforcement Agency: CITY OF NEWPORT BEACH JlPemrit Number: X2o19-0995
Project Address: 3501 Jamboree, Ste. 540
City Newpon Beach IZip Code: 9'660
W 1. Automatic Daylight Controls meet all requirements for Automatic Daylight Control devices in the Title 20
Appliance Efficiency Regulations, including the following:
a. Is capable of reducing the power consumption in response to measured daylight either directly or by
sending and receiving signals;
b. If the system includes a dimmer, complies with the Dimmer Control device requirements in the Title 20
Appliance Efficiency Regulations.
c. Automatically return to its most recent time delay settings within 60 minutes when put in calibration
mode;
d. Has a set point control that easily distinguishes settings to within 10 percent of full scale adjustment;
e. Has a light sensor that has a linear response within 5 percent accuracy over the range of illuminance
measured by the light sensor;
f. Has a light sensor that is physically separated from where the calibration adjustments are made, or is
capable of being calibrated in a manner that the person initiating the calibration is remote from the sensor
during calibration to avoid influencing calibration accuracy; and
g. Complies with the Title 20 requirements for photo controls if the system contains a photo control
component.
2. Photo Controls meet all requirements for Photo Control devices in the Title 20 Appliance Efficiency
Regulations, including the following that it does not have a mechanical device that permits disabling of the
control.
r',. G. The EMCS or Lighting Control System functions as a Dimmer and meets all requirements for a Dimmer Control
device in the Title 20 Appliance Efficiency Regulations, including the following:
1. Is capable of reducing power consumption by a minimum of 65 percent when the dimmer is at its lowest level;
2. Includes an off position which produces a zero lumen output; and
3. Does not consume more than 1 watt per lighting dimmer switch leg when in the off position.
4. Dimmer controls that can directly control lamps provide electrical outputs to lamps for reduced flicker operation
through the dimming range so that the light output has an amplitude modulation of less than 30 percent for
frequencies less than 200 Hz without causing premature lamp failure.
5. If designed for use in three way circuits is capable of turning lights off, and to the level set by the dimmer if the
lights are off.
H. The EMCS or Lighting Control System meets the following requirements:
1. Is capable of automatically turning off controlled lights in the area no more than 30 minutes after the area has
been vacated;
2. Allows all lights to be manually turned off regardless of the status of occupancy; and
3. Has a visible status signal that indicates that the device is operating properly, or that it has failed or
malfunctioned. The visible status signal may have an override switch that turns off the signal.
4. All occupant sensing devices that utilize ultrasonic radiation for detection of occupants meet the Ultrasound
Maximum Decibel Values in the Title 20 Appliance Efficiency Regulations
S. All occupant sensing devices that utilize microwave radiation for detection of occupants meet the radiation
requirements in the Title 20 Appliance Efficiency Regulations
6. Occupant sensing devices incorporating dimming comply with the requirements for dimmer controls in the Title 20
Appliance Efficiency Regulations
7. The EMCS or Lighting Control System functions as one or more of the Occupant Sensing Controls Checked Below:
W, a. Occupant Sensors meeting all applicable requirements for Occupant Sensor Control devices in the Title 20
Appliance Efficiency Regulations
b. Motion Sensors meeting all applicable requirements for Motion Sensor Controls devices in the Title 20
Appliance Efficiency Regulations, including that motion sensors are rated for outdoor use.
c. Vacancy Sensors meeting all applicable requirements for Vacancy Sensor Controls devices in the Title 20
Appliance Efficiency Regulations, including the following:
i. Does not turn on lighting automatically and does not incorporate DIP switches, or other manual means, for
conversion between manual and automatic functionality;
ii. Has a grace period of no more than 30 seconds andnoless than 15 seconds to turn on lighting
automatically after the sensor has timed out; and
iii. Does not have an override switch that disables the sensor.
This is page 3 of 5
r d. Partial -ON Sensors meeting all applicable requirements for partial on sensing devices in the Title 20
Appliance Efficiency Regulations, including the following:
L Has two poles each with automatic -off functionality; .
ii. Has one pole that is manual -on and does not incorporate DIP switches, or other manual means, for
conversion between manual and automatic functionality; and
ill. Has one pole that is automatic -on and is not be capable of conversion by the user to manual -on
functionality.
1771' e. Partial -OFF Sensors meet all applicable requirements for partial off sensing devices in the Title 20
Appliance Efficiency Regulations, including the following:
i. Has two poles;
ii. Has one pole that is manual -on and manual off; and
iii. Has one pole that is automatic -on and automatic -off and is not capable of conversion by the user to
manual -on only functionality.
f. Occupant Sensing Control systems consist of a combination of single or multi-level Occupant, Motion, or
Vacancy Sensor Controls, and all components installed to comply with manual -on requirements are not
capable of conversion by the user from manual -on to automatic -on functionality.
PART 3 Requirements for which the control is being installed to complied with:
Identify all requirements in the Standards for which the EMCS or Lighting Control System is installed to function as and complies
with:
Check all that are applicable.
FW
A. Section 130.1(a) Area Controls.
17,
B. Section 130.1(b) Multi -Level Lighting Controls
ri
C. Section 130.1 (c) Shut -OFF Controls
V
D. Section 130.1 (d) Automatic Daylighting Controls.
r
E. Section 130.1 (e) Demand Responsive Controls.
r
F. Section 130.5 (d) Circuit Controls for 120 -Volt Receptacles.
F71
G. To qualify for the PAF for a Partial -ON Occupant Sensing Control in TABLE 140.6-A
r
H. To qualify for the PAF for an occupant sensing control controlling the general lighting in large open plan office
areas above workstations, in accordance with TABLE 140.6-A
F7
I. To qualify for the PAF for a Manual Dimming System PAF or a Multiscene Programmable Dimming System PAF in
TABLE 140.6-A
FL
]. To qualify for the PAF for a Demand Responsive Control in TABLE 140.6-A
F
K. To qualify for the PAF for Combined Manual Dimming plus Partial -ON Occupant Sensing Control in TABLE 140.6-A
This is page 4 of 5
OF LNSTALLATION
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT
I certify that this Certificate of Acceptance document Is accurate and complete.
Documentation Author Bruce Woodhall Company Name
Name Helmco Electric, Inc.
Address
City
17985 Sky Park Circle, Ste. 3
Irvine
Zip Code
Phone
92614
(661)468-5638
CEA/ATT Certification
Author Signature
Identification (if TC -A217220
applicable)
Date of Signature: 06/17/2019
RESPONSIBLE PERSON'S DECLARATION STATEMENT
I certify the following under penalty of perjury, under the laws of the State of California:
1. 1 am the Field Technician, or the Field Technician is acting on my behalf as my employee or my agent and I have reviewed the information provided on this
Certificate of Acceptance.
2. I am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design,
construction or installation of features, materials, components, or manufactured devices for the scope of work identified on this Certificate of Acceptance and
attest to the declarations in this statement (responsible acceptance person).
3. The information provided on this Certificate of Acceptance substantiates that the construction or installation identified on this Certificate of Acceptance
complies with the acceptance requirements indicated in the plans and specifications approved by the enforcement agency, and conforms to the applicable
acceptance requirements and procedures specified In Reference Nonresidential Appendix NA].
4. I have confirmed that the Certificate(s) of Installation for the construction or installation identified on this Certificate of Acceptance has been completed and
is posted or made available with the building permits) Issued for the building.
5. I will ensure that a completed, signed copy of this Certificate of Acceptance shall be posted, or made available with the building permits) issued for the
building, and made available to the enforcement agency for all applicable inspections. I understand that a signed copy of this Certificate of Acceptance is
required to be included with the documentation the builder provides to the building owner at occupancy.
Responsible Acceptance Bruce Woodhall Company Name Helmco Electric, Inc.
Person Name
Address: 17985 Sky Park Clrcle, Ste. 3 City Irvine
Zip Code 92614 Phone (661)468-5638
CSLB License 933623 Position with Company (Title) Superintendent
Responsible Acceptance Person Signature
Date of Signature: 06/17/2019
This is page 5 of 5
AUTOMATIC DAYLIGHTING CONTROL ACCEPTANCE DOCUMENT
Enforcement Agency Use: Checked by/Date
Check boxes for all pages of this NRCA-LTl-03-A completed and included in this submittal
E3.0
NR-LTI-03-A Page
Construction Inspection. This page required for all submittals.
E3
3R&C$A-LTI-03-A Page
Continuous dimming control functional performance test—watt-meteroramp-meter measurement
NRC LTI-03-A Page
Stepped Switching/ Stepped Dimming functional performance test—watt-meter or amp -meter measurement
Cl
NRCA-LTI-03-A Page
Continuous dimming control functional performance test— light meter power measurement, and default look -up
7&8
table of fraction of rated powerversus fraction of rated light output.
Cl
NRCA-LTI-03-A Page
Stepped Switching/ Stepped Dimming functional performance test— based on light output
9&10
1. NA7.6.1.1 Construction Inspection:
1. Drawing of Daylit Zone(s) must be shown on plans or attached to this compliance document. By checking this
box, technician certifies that plans have been attached to this webform
70
Document Name and Page #'s
Lighting Plan E-3.0
Add Control Systems below. If sampling method is used in accordance with NA7.6.1.2. If adding, attach a page with names of other controls In sample (only for
buildings with > 5 daylight control systems, sample group glazing same orientation)
Lighting Plan
Lighting Plan
Plans Page Number
E3.0
Check if Tested Control Is Representative of Sample
r
2. Svstem Information
Zone Type: Skyl it (Sky), Primary Si del it (PS), or Secondary Side l it (SS)
Control Type: Continuous Dimming with more than 30 light levels (C), Stepped Dimming (SD), Switching (SW)
Design Footcandles: (Enter footcandle (fc) value or ,U" If unknown):
Control Loop Type: Open Loop (OL), Closed Loop (CL)
Sensor Location: Outside (0), Inside Skylight (IS), Near Windows facing out (NW), In Controlled Zone (CZ)
Sensor Location is Appropriate to Control Loop Type: (Yes/No) If control loop type is Open Loop (OL): Enter yes (Y) if location =
Outside (0), Inside Skylight (IS), or Near Windows facing out (NW); otherwise, enter no (N). If Control loop type is Closed Loop
(CL): Enter yes (Y) if location = In Controlled Zone (CZ); otherwise, enter no (N).
Control Adjustments are in Appropriate Location (Yes/No): Yes, If Readily Accessible or Yes if in Ceiling less than or equal to 11 ft,
es II
This is page 1 of 5
No for all other.
4. Has Documentation Been Provided by the Installer:
Installation Manuals and Calibration Instructions Provided to Building Owner: (Yes/No)
Yes
Location of Light Sensor on Plans: (Yes/No)
Yes
Location of Light Sensor on Plans: (Page Number)
E-3.0
5. Separate Controls of Luminaires in Daylit Zones:
Are luminaires controlled by automatic daylighting controls only in daylit zones: (Yes/No)
Yes
Separately circuited for daylit zones by windows and daylit zones under skylights: (Yes/No)
Yes
6. Daylighting Control Device Certification
Daylighting control has been certified in accordance with §110.9: (Yes/No)
Yes
Construction Inspection PASS/FAIL. If all responses on Construction Inspection pages 1 & 2 are complete and all Yes/No questions
Pass
have a Yes response, the tests PASS; If any responses on this page are incomplete OR there are any No responses, the tests FAIL
PASS/FAIL Evaluation (check one):
(« PASS: If all responses on Construction Inspection pages 1 & 2 are complete and all Yes/No questions have a Yes (Y) response, the
tests PASS
FAIL: Any applicable Construction Inspection responses are incomplete OR there Is one or more negative (N - no) responses in any applicable
Functional Performance Testing Requirements section. System does not pass and is NOT eligible for Certificate of Occupancy according to Section to-
103(a)3B. Fix pro Is lemis) and retest until the system (s) passes all portions of this test before retesting and resubmitting NRCA -LTI-03-A
with PASSED
test to the enforcement agency. Describe below the failure mode and corrective action needed.
This is page 2 of 5
ACCEPTANCE
BEACH
9?660
2. NA7.6.1.2.1 Functional Performance Testing — Continuous Dimming Systems:
Power estimation using light meter measurement
Complete all tests on page 7 & 8 (No Daylight Test, Full Daylight Test, and Partial Daylight Test) and fill out Pass/Fall section on Page S.
Lighting Plan
I Svstem Information
a. Control Loop Type: Open Loop or Closed Loop? (0 or C)
I
F. Indicate if Mandatory control - M (required for skylit zone or primary smart zone with installed general lighting power > 120 W);
for Control Credit - CC; or Voluntary not fmcredit -V (Pi, CC, V)
33.2
c, If automatic daylighting controls are mandatory, are all general lighting luminaires in daylit zones controlled by automatic
daylight controls? (Yes/No)
Yes
d. General lighting design footcandles. (Enter footcandle (FC) value, or "U" If unknown.)
u
e. Power estimation method. (see fine q) Default ratio of power to light (Dfc), cut -sheet ratio of power to light (CSfc) If CSFc -
attach cut -sheet. Enter Dfc or CSfc
Dfc
Step 1: Identify Reference Location
(location where minimum daylight Illuminance is measured in zone served by the controlled liphtinq.)
E Method Used: Illuminance or Distance? (I or D)
61.2
Override daylight control system and drive electric lights to highest light level for the following:
33.2
g. Highest light level fc - enter measured controlled electric lighting footcandles (fc)
33.2
In. Indicate whether this is Full Output (FO), or Task Tuned (Lumen Maintenance) (TT)
FO
Ste 2: No Daylight Test controls enabled & daylight less than 1 fc at reference location
1. Method Used: Night time manual measurement (Night), Night Time Illuminance Logging (Log), Cover Fenestration (CF), Cover
Night
Open Loop Photosensor(COLP)
Yes
j. Reference Illuminance (footcandles) as measured at Reference Location (see Step 1). Enter footcandles
33.2
k. Enter Y If either of the following statements are true: If line In = F0; [Reference Illuminance (line J)] / [Full Output fc (line g)] >
Yes
70%? or [Reference Illuminance (line j)] / [design footcandles (line d)] > 800/s? (Yes/No)
Step 3: Full Daylight Test conducted when daylight > 150% of reference illuminance (line j)
I. Daylight illuminance (light level with electric lighting turned off) measured at Reference Location (fc)
2g
m. Daylight illuminance (line 1) greater than Reference Illuminance (line j)? (Yes/No)
No
or
n. Total (daylight + electric light) illuminance measured at the Reference Location (fc).
61.2
o. Electric lighting illuminance at the Reference Location (fc) [(line n) - (line I)].
33.2
p. Electric lighting illuminance (line o) divided by Highest Light Level fc Olne g). Enter %.
loo
q. Dimmed luminaire fraction of rated power. Attach manufacturer's cut -sheet or use default graph of rated power to light output.
Label applicable control system on cut -sheet or graph. Enter fraction of rated power In %.
r. System Power Reduction = [I - line q]
100
s. Is System Power Reduction (line r) > 6595 when line h = FO, or > 56% when line h = TT (Yes/No).
Yes
I. With uncontrolled lights also on, no lamps dimmed outside of daylit zone by control (Yes/No).
Yes
u. Dimmed lamps have stable output, no perceptible flicker (Yes/No).
Yes
This is page 3 of 5
PASSJFAIL Evaluation (check one):
PASS: All applicable Construction Inspection responses are complete and all applicable Functional Performance Testing Requirements responses are
positive (Y - yes)
FAIL: Any applicable Construction Inspection responses are Incomplete OR there is one m more negative (N - no) responses in any applicable
Functional Performance Testing Requirements section. System does not pass and Is NOT eligible for Certificate of Occupancy according to Section 10-
103(a)30, Fix prob I a in (s) and retest until the systems) passes all portions of this test before retesting and iesu b m l tti ng A RCA-LTI -0 3 -A with PASSED
test to the an force men agency. Describe below the failure mode and corrective action needed.
This is page 4 of 5
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT
I ceTify that this Certlnaate of Acceptance documentation Is accurate and complete.
Documendirm, Aetna, Name
Caere, wo.Po g
Address
17995 Sky park Circle, Ste.I
ZIP Code
92619
CEA/ATT Certification Identification (If
applicable) TC -A2172211
.3iww 1,kKDl.�(9
Data of Shchalbric
06/17/2019
Company Name
dormice Electric. In,
City
Irvine
Pnmle
(6G1)A G9-5639
Aetna r 519natum
X2019-0995
FIELD TECHNICIAN'S DECLARATION STATEMENT
I chiral, the following under penalty of Pacific, near the laws of the State of Cg1f mla:
1. The information provided on this CertiOCata of Acceptance is true and correct.
2. lam the person who performed the acceptance verification reported be this Certificate or Acceptme(Field Tecnlldan).
3. The yerpriion or Installation Identified on this Certlfcats of Acceptance complies with be applieahle acceptance regWremenl indicated in the plans and spearpe lour approved by the enforcement agency, and
mnforms In the applicable acceptance requirements and pmcetln,p
res ea ort in Reference NonaSdential Armorer. NA1,
d.I bave mnhrnleb that the Cerhflcaps,) of Installation nor the so drodai or Imstllatinn ldentlh 1onthis Certificate or Aaeptance has been completed and signed by the.......:tile huiloer/rel ller end has been
The ed or made aval,ble'.elth the building permit(,) Issued IF the buil0e,
Full Tachmcian Name Company Name
Bruce Wnotllwll f{ebnco Electric, Inc.
Address:
17City
995 Sky park Cindy, Ste.] Irvine
Zip Code Phone
92614 (G61)}68-5639
ATT CertI@atlon Identification TCA.17220 Persian with Company(lithe) Superintendent
Field neverhan Signature
z Lk
Date of Signature:
06/1]%2919
RESPONSIBLE PERSON'S DECLARATION STATEMENT
[certify me Allowing under penalty of perjury, under the laws of the State of California:
1.I am the Field Iarcbnlcier, or the Field Technician Is acting on my behalf as my employee mmy agent and 1 have I'evlewed the information provided on this Certificate of Aaeptance.
2. lam eligible under Division 3 of the Business and professions Corte in the applicable dassficauon to street resp isnot Alt, for the ,dim design, cre struction or Installation of features, hwteriels, components. or
nutcturad devices far the sopa of body Identified on this Certificate of Aaepmnce and attest to [he declamlim, a Pis statement (..Vonslble accxVtance person).
3. TheInformation provided oilthis Certificate of Acceptance substantiates that the construction or Installation identified on this Catlhcate of Acceptance complies with the acceptance hear thins Indicted In tilePlans
and so migrations approved by the enforcement agency, and mndmis to the applicable acceptance requirements and phncedures sposeled In Reference Nonresidential Appendix has.
9. I neve confirmed that the Cerdfliote(s)of Installation for the construction or installation Identified an this CertiRcate of Acceptance has been completed and is posted or made avaAsble wIM tlm bunting pedmiy's)
sued for the fell5.1 will ensure that a mmpleten, sl.ned copy of this Coldfloate of Acceptance shall be posted. or mantle available with the builNnp permit(s)Issued for the building, and made available m the enforcement agency for all
applicable... specieer. l understood that a signed copy of this Certificate of Acceptance.:, required to contradicted with tine documentation the bniltler provides to the fell ...or at ocmpancy.
Responsible Acceptance Person Name Bruce Waodhlll Economy Name Helmet Electric, Inc.
Audi is
17Cly
995 Sky Park Cindy, Site Irvine
Zip Code Phone
92614 (661)468-5638
CSI.B License weiflon whim Company (TI[le)
933623 Superintendent
Responsible Acceptance parser 59naters rk�
IJYSa I1f -_
Date of Si lnamre:
06/1112919
This is page 5 of 5